Turnover has always been a challenge in healthcare, but COVID-19 has put the issue front and center. The 2022 NSI National Health Care & RN Retention Report estimates that hospital turnover increased by 6.4% between 2021 and 2022 and currently stands at 25.9%. The cost of turnover can also be staggering, with the average hospital spending $5.2-$9 million on it every year. These costs are particularly felt in the need to train a constant stream of new clinicians. This burden tends to fall heaviest on nursing departments, which have seen a higher rate of turnover than all other clinical groups.
Turnover is a complicated, industry-wide problem, but you can lessen its impact on your healthcare organization. Onboarding and training clinicians is a significant source of the cost of turnover, but with the right tools you can reduce the time it takes to onboard new hires and develop an effective EHR training strategy that leads to higher clinician satisfaction.
Understanding the Increase in Healthcare Turnover Rates
Many elements contribute to the increased level of turnover in healthcare. KLAS research recently published a report outlining several key metrics that are most correlated to increases in turnover. Here are some of the top issues common among those clinicians reporting plans to leave their organization.
- Feeling completely burned out: Burnout is a multifaceted issue affecting almost every aspect of the care continuum. According to KLAS Research, burnout has spiked since the start of the pandemic from approximately 25% of clinicians reporting burnout to approximately one-third. While the pandemic is a primary driver in this increase inefficient use of the Electronic Health Record (EHR) and IT tools and after-hours workloads continue to be significant contributors.
- Distrust in the IT/organizational leadership: A key factor in whether a clinician feels burned out and has plans to leave their organization comes down to their trust in IT and organizational leadership. By prioritizing the EHR training strategy and clinician support at the leadership level, organizations can make strides in improving trust.
- Dissatisfaction with the EHR: While the EHR is a very effective tool, it is also a key source of frustration and burnout among clinicians. Improvements in training have been shown to improve EHR satisfaction. According to a 2021 KLAS report, several healthcare organizations, including Intermountain Healthcare, have seen an improvement in overall satisfaction through improvements to training.
- Dissatisfaction with EHR training: KLAS Research data shows that quality initial and ongoing training is the primary driver of EHR satisfaction. Improving how a clinician feels about training within their organization can have dramatic effects on lowering turnover in your organization.
Clinician turnover in healthcare is one of many challenges facing the industry. This multifaceted issue will require an array of solutions. Improving the training experience for clinicians is one of the most impactful tools organizations have at their disposal.
What Makes Up a Successful EHR Training Strategy?
While there is not necessarily a one-size-fits-all method for successful training, there are few key elements that organizations should focus on. Based on leading research and our clients’ experiences, an effective training strategy should include the following:
- A strong ‘why’: Onboarding is a great opportunity to build unity for clinicians through helping them understand the ‘why’ behind the workflows. EHRs are used differently at different organizations. Helping clinicians understand why they are expected to document in a certain way can help reduce the use of workarounds, build alignment and foster trust.
- Checks and balances: Clinicians are eager to get started, but they can easily become frustrated without proper training. Organizations that utilize assessments with built-in follow-up training report greater knowledge retention.
- Workflow specific: Both initial and ongoing training needs to address the specific clinical focus area. Nurses and physicians do not utilize the same workflows and thus need training specific to their role and department. When training is mostly tailored to providers, nurses feel their needs are not met. Gathering clinical input for content creation is a key component of effective training. One common frustration is that the screen shares used in training are different than what a clinician encounters on the floor.
- Timing: Training has historically been a time-consuming, in-person event that hasn’t always met the needs of clinicians. The 2019 pandemic forced organizations to start looking at other options and many started to utilize virtual and online trainings, however, these have not been particularly well received as it still isn’t addressing the needs of clinicians who are struggling at the point-of-care. Being able to deliver training to a clinician at their moment of need has been an area that some organizations have attempted to tackle using rounding informaticists, which can be costly, and only effective in the acute setting where access to these resources is available. Leaving smaller hospitals and clinics, or providers working the night shift, to fend for themselves.
- Agile: The EHRs of today are constantly changing. Epic rolls out quarterly updates that change workflows and UX, which means clinicians must keep up with new or changed workflows. Many organizations don’t have much more than email updates to communicate the changes that have been made, leaving clinicians frustrated that they are constantly creating new muscle memory in their documentation. Along with upgrades are new regulatory changes that impact how clinicians interact with their EHR. Staying on top of all these changes can be an overwhelming task for clinicians.
An comprehensive EHR training strategy is one of the most important ways that organizations show their commitment to the success of their clinicians. Training is an investment in not only the efficiency of clinicians, but their ability to deliver quality care to their patients.
How uPerform Helps Set the Foundation of an Effective EHR Training Strategy
To create a successful EHR training strategy, you need the right tools. uPerform® is a comprehensive learning platform that can complement your learning management system (LMS) to speed up onboarding and managing on-the-job, formal and informal ongoing training. Its content creation tool enables training teams to produce content in as little as half the time. Simply record a process directly in the desired workflow and choose from multiple output formats, including tip sheets, videos, and interactive simulations. Content is then delivered to end users directly in their workflow for seamless, on-demand access to support tools.
uPerform is proven to decrease clinician time in training by 45% while providing a better training experience. A hybrid approach to training can eliminate the time end users spend on redundant or irrelevant lessons by tailoring courses to the user’s role, specialty or department. Efficient training has been proven to boost Net EHR Satisfaction Scores and get clinicians on the job faster. For example, read how Baylor Scott & White Health improved ongoing EHR education and satisfaction with uPerform in the Arch Collaborative case study.
uPerform is a cloud-based platform that can work with all your enterprise applications to provide just-in-time training and support to end users. It fully integrates with Epic, other EHRs, enterprise software (Workday, Oracle, etc.), and learning tools like your LMS to provide a central location for learning resources and software support.
Healthcare onboarding with uPerform
One of the top healthcare system challenges is high turnover, so many organizations are looking for ways to reduce its impact. Better training plays a vital role in the clinician onboarding experience, minimizing how much time they spend off the job.
uPerform’s scalable, intuitive platform makes onboarding and training simple and fast. With proven results and a host of valuable learning tools, you can save significantly on the costs associated with high turnover while keeping employees engaged.
Case Study: Baylor Scott & White Health (BSW) improves EHR satisfaction
According to a study conducted by KLAS Arch Collaborative, users of uPerform at BSW report higher satisfaction with their EHR and training experience than nonusers. uPerform helped BSW make learning content more accessible and eased the learning curves for frequent Epic upgrades.